Housing Vancouver’s mentally ill costs little more than leaving them on street: study

People walk through a back alley in the downtown eastside area of Vancouver. Providing homes to Vancouver’s highest-needs mentally ill people costs about the same as leaving them on the street to rotate through shelters, emergency rooms and jail cells, according to a landmark national study. The At Home study, which involved 2,200 hard-to-house people with mental illness in five Canadian cities, placed participants in housing and provided them with financial, medical and moral support.

Photograph by: Jonathan Hayward
, Canadian Press

Providing homes to Vancouver’s highest-needs mentally ill people costs about the same as leaving them on the street to rotate through shelters, emergency rooms and jail cells, according to a landmark national study.

The At Home study, which involved 2,200 hard-to-house people with mental illness in five Canadian cities, placed participants in housing and provided them with financial, medical and moral support. A just-completed cost analysis shows that, across the country, it was on average 11-per-cent more expensive to house the most needy study participants, compared to leaving them to rely on emergency services.

The cost breakdown for the Vancouver portion of the study, which involved 500 participants, has not yet been released to the public. But the lead investigator, Simon Fraser University Prof. Julian Somers, said in an interview that the cost to house and support the Vancouver high-needs group was almost identical to the cost of leaving them on the street. Somers believes Vancouver’s better cost comparison outcome is due, in part, to the local participants facing tougher circumstances and using more emergency services before entering the study.

Somers argued that even a small increase in cost is worth the net benefit to society of having these participants healthier and happier when they have a safe place to live and regular access to medical professionals, rather than being homeless without consistent medical care.

“Even if it costs a little bit more, it’s highly worthwhile,” he said.

The study may bolster the position of Mayor Gregor Robertson, who has made ending homelessness and providing better care to the mentally ill a top priority.

City hall announced Tuesday that it was creating a Mayor’s Task Force on Mental Health and Addictions, as part of an effort to address “the crisis of severe, untreated mental illness in Vancouver.”

Somers and his co-researchers have made presentations to city hall about his study’s “housing first” model, and he hopes the mayor’s task force will consider this approach.

The concept behind the At Home study is to first provide a home for troubled mentally ill people, and then provide support so they can achieve their own goals — whether that is reducing drug use or learning to cook or reconnecting with family.

A cost analysis of the landmark $110-million national study, which began in 2009 and ended in March, has recently been completed by McGill University Prof. Eric Latimer. The results, which will be presented at an international conference in Boston next month, show:

• The annual cost to house and support the highest-needs group was $47,754, compared to $42,992 for those in unstable housing who rely heavily on emergency services. That is an 11-per-cent jump in cost.

• The annual cost to house and support the moderate-needs group in the study was $36,585, compared to $31,998 for those left on the street. That was a 13-per-cent jump in price.

Somers said the Vancouver figures for the high-needs group were almost “a wash.” For the Vancouver moderate-needs group, he said it was “modestly” more expensive to house and support the participants.

Somers said the 500 participants in the $30-million Vancouver arm of the study are exactly the type of people Robertson and Vancouver police Chief Jim Chu are talking about when they talk about Vancouver’s most challenging, homeless mentally ill people. Therefore, he thinks it is a “massive overreaction” when Robertson and Chu say they need a new 300-bed secure facility to house these troubled folks.

Somers said his study proves that the vast majority of them can “go directly to Kerrisdale, not Riverview” if they are given the choices and support to live independently.

Statistics from the Vancouver portion of the study — where 200 people were put in apartments throughout the city, 100 were put in a hotel-type building, and 200 were in a control group that received no services from the study — illustrate why paying for rent and support in exchange for stability may not be a drain on taxpayers.

All 500 participants, for example, visited a hospital emergency room an average of 4.8 times a year before entering the study. Twelve months after enrolling, the number of visits dropped to 3.8 for those in the apartments and climbed to more than seven for those left on the street.

The number of criminal convictions for participants living in the apartments, compared to before they entered the study, dropped by 71 per cent after two years.

The participants’ quality of life and community interaction also drastically improved compared to those who did not receive housing.

The costs for people who continue to rely on emergency services add up quickly.

According to The Real Cost of Homelessness, a 2012 study that quantified costs across the country, the average monthly price in 2007 of housing people was $1,932 for a shelter bed, $4,333 for provincial jail or $10,900 for a hospital bed. The study also found homeless people made 2.1 annual trips to the emergency room.

The B.C. Ambulance Service, in response to a question from The Sun Wednesday, said it was difficult to calculate the precise price of an ambulance ride, but said the $530 charged to non-B.C. residents may be an indicator of the overall costs for the service.

People walk through a back alley in the downtown eastside area of Vancouver. Providing homes to Vancouver’s highest-needs mentally ill people costs about the same as leaving them on the street to rotate through shelters, emergency rooms and jail cells, according to a landmark national study. The At Home study, which involved 2,200 hard-to-house people with mental illness in five Canadian cities, placed participants in housing and provided them with financial, medical and moral support.

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